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by beiller 1882 days ago
If it was more deadly it would spread less quickly. That's how diseases work from my vague university memories of an epidemiology course. They are on a spectrum of deadly to contagious.
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What actually causes this though? For example, take something like HIV that takes a long time to show symptoms, but have an airborne version of it. Do the things that make viruses airborne also keep them from having a long gestation period and also highly lethal?
> Do the things that make viruses airborne also keep them from having a long gestation period and also highly lethal?

Surviving airborne before the advent of buildings meant surviving outside in direct sunlight with little in the way of protection from droplets or anything else. Organisms have a limited amount of abstract "evolutionary capital" and the costs, so to speak, of developing adaptations to survive airborne and evade an active immune system are astronomical. It's not impossible, but the two "features" work against each other during the development phase.

(Not an immunologist/virologist/biologist of any stripe. The following is my rough layman's understanding of the answer to this question. Would love to be corrected by someone with more formal knowledge of the subject.)

My understanding is that the main reason is a biological application of the principle of parsimony: Evolutionarily, organisms don't generally evolve lots of different things all at once. Thus, if you have a novel variant of a virus, it is highly likely to be mostly like existing variants, but with a very small number of changes.

Basically, you can think of it as the virus having to hit a particular threshold of a mutation direction that increases transmissibility to become widely-spread, but also has to hit a particular threshold of a mutation direction that increases lethality in order to become very dangerous.

As soon as it hits that transmissibility threshold, that is the version of the virus that's going to spread, and hitting both those thresholds at the same time is going to be incredibly rare.

What's much more likely (and genuinely concerning) is the possibility that a virus that has already become highly transmissible evolves more in the "lethality" direction and goes from being a widespread nuisance to being a deadly pandemic. The longer we let something like COVID remain widespread, as I understand it, the more likely we are to see a variant emerge that retains its high transmissibility but also gains a higher lethality. However, as we can see from the fact that the bodies are not piling up in the streets, even after nearly a year and a half of a pandemic form of a particular virus, it's by no means guaranteed that something like that will happen, even at a small scale.

This is such an interesting question, I hope it doesn't get buried before someone knowledgeable answers it.

We all know the more aggressive a pathogen is, the more it paints itself into a corner because it's burning its bridges. Something like airborne HIV would be really scary.

My guess is that airborne diseases are not weaker, but that evolution has selected for resistance against those because they spread fast among the population.

This is unfortunately just not correct in real life. It’s a good representation of general behavior/trends, but for instance Smallpox was around since at least 500 BC, and still had a 35% fatality rate until it was eradicated in the 70s.

The more times you roll the dice, the more often you’ll get that magic combo of lethal and highly transmissible. For the most part it doesn’t favor it, but that just makes it an outlier when it does, not impossible.

At least a part of it is probably the human factor. The big "PR" problem we have with fighting the epidemic is that a lot of people won't have much (visible) problems. If COVID would lead to a slow and painful death 99% of the time, there were probably far fewer people trying to get it or using the herd immunity strategy.
I don't think we know what causes it. It is mainly just observed. What causes this is a very active area of study. Probably some output of a "evolutionary" process of how viruii mutate but my knowledge is very little :)